Purpose: To determine the distribution of the difference between the horizontal and vertical dark-adapted entrance pupil diameters (PDs) in normal individuals.
Setting: Texas Tech University Health Sciences Center, Lubbock, Texas, USA.
Methods: In this observational cohort study, high-magnification infrared pupil photography was performed of the right eye of 26 normal volunteers from 20 to 47 years of age. The horizontal and vertical PDs were measured using commercially available digital-image software, taking into account the effect of photographic parallax.
Results: In 24 subjects (85%), the vertical PD was larger than the horizontal PD; in 8 subjects (31%), it was 0.30 mm to 0.50 mm larger. In 2 subjects, the horizontal diameter was slightly larger but the difference was <0.10 mm. The mean horizontal to vertical PD ratio was 0.97.
Conclusions: In this study population, the vertical PD was larger than the horizontal PD in most subjects. Although the difference was a fraction of the total PD, it may be important for laser refractive surgery planning and preoperative risk counseling of some patients.